Organization
SOUTHLAKE KIDNEY SPECIALISTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHARMILA DEVIDOSS MD (PHYSICIAN)
(817) 733-9367
Entity
Organization
Contact information
Practice address
630 N KIMBALL AVE STE 100, SOUTHLAKE, TX 76092-6886
(817) 733-9367
Mailing address
701 MONTE CARLO DR, SOUTHLAKE, TX 76092-1159
(817) 733-9367
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
09/05/2019
Last updated
01/29/2020
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